Three iIIustrative cases of children with depression managed at the University Hospital, Kuala Lumpur; showed similar features of depressive illness and the association with family problems and depressed parents as described in Western countries. The Multi-Axia System of classification (MAS), as suggested in a WHO publication provided a useful means of classification as well as management. Two of the axes are biological and psycho-social factors in the aetiology of psychiatric syndromes (the third axis) and the intellectual level (the second axis of the child). Appropriate counselling of the parents is an important part in the management of depression in children.
With about 1% of Malaysian medical practitioners being psychiatrist, the patients need the psychiatric skill and care of general practitioners for both early referral and follow-up care. The psychological reactions aroused by the mentally ill patients may be jointly managed by the doctors and their families. The primary care doctor can play an effective therapeutic and supporting role in the rehabilitation of the patient that may include, when available, other workers in social and psychiatric services.
Marital and sexual counselling is an important aspect of the work of a primary care physician or family practitioner. The preventive aspect of this counselling is fairly obvious in the practice of family planning. The medical practitioners have to be aware of the socio-cultural background of his patients or refer to qualified allied health professionals.